Positive pressure catheter



May 17, 1960 w. A. GANTS POSITIVE PRESSURE. CATHETER Filed Sept. 10,1956 IN VEN TOR.

M'Z/z'a m A. 6B 7256 2,936,760 j I rosmvn'rnnssunn CATHETER William A.Gants, Barrlngton, .R.I., assignor to Dave] Rubber Company, acorporationof Rhode Island The instant invention relates generally tosurgical rubber apparatus and the like and has particular reference to anovel catheter construction.

- A primary object of'the instant invention is the provision of acatheter particularly useful in connection with positive pressureurethrography:

urethraand 't herr introducing a contrast media under moderate pressure,whereby 'said media will pene' trate into any diverticula or lesionsthat exist in communi pressure urethrography technique to be effectivelycar- Anotherobject of my invention is the provision of a catheter'whichwill permit the introduction of a contrast niedia, under pressure,into the urethra" while at the. same time closing both ends of theurethra, thereby preventing Still another object ofmy invention is theprovisiomof ried out. My catheter will permit the introduction of acontrast media under pressure into the urethra, and at the same time,the presence of a fixed. balloon carried by the catheter and locatedwithin the patients bladder, in combination with'an eye on the cathetershaft proximal to this balloon, and in combination further with asliding balloon on the catheter shaft, will permit the effective closureof both ends of the urethra. This insures that the contrast materialswhich are introduced into the urethra will be maintained therein withoutleaking' of same through eitherurethral orifice, which leaking wouldobviously render the whole technique ineffectual since the contrastmedia would then not be pressurized sufliciently' to penetrate into thevarious diverticular present within the urethra. At the same time, mycatheter construction is such'that, although the ends of the urethra areeffectively blockedfthere is no substantial. penetration into theurethral lumen by the balloons which function as the blocking means.Impingement of the balloons on the urethral lumen would result in thenon-visualization of a positive pressure catheter which is simple andeeonorni-v cally feasible to manufacture but which, nevertheless ,.is

effective and durable in use. I I

Other objects, features and advantages of the invention will becomeapparent as the description thereof proceeds the portions of the urethraso covered land render the location of diverticula in those portionsdiflicult, if not impossible. i Referring'now to the drawings, theillustrated'cathe'ter generally designated at 10'i s preferably formedof flexible rubber, such as latex; and includes an elongated, generallywhen considered in connection with the accompanying illustrativedrawings.

In the drawings which illustrate the best mode presently contemplated bymefor carrying out my invention:

Fig. l is a side elevation of a positive pressure catheter constructedin accordance with my invention, the balloons being in non-inflatedcondition;

.f Fig. 2 isa fragmentary sectlonal elevation, onan .en-

larged scale, of my improved catheteri; K

Fig. 3 is a section taken-on line 3-3 of Fig. 2; and

. ,ig, -4 is. a fragmentary sideelevation or'my catheter with bothballoons in' distended position.

Suburethral diverticula in the female are thought by in existingcystoscopic and urethrographic diagnostic techniques. Existingtechniques have proven particularly ineffectual in connection with thelocation of relatively small diverticula, which probably are much morecommon than the large ones, and which most frequently develop into largelesions. Thus it is of extreme importance that a diagnostic technique beavailable for the location of these relatively small diverticula, and tothis end, it has been found that a relatively new technique, known aspositive pressure urethrography, has met this need and has been foundcapable of demonstrating diverticula discovered at cystoscopy, as wellas visualizing diverticula which have been overlooked at one or morecystoscopic examinations, despite careful scrutiny of the urethra withstandard cystoscopic equipment.

Broadly speaking, positive pressure urethrography works on the principleof blocking off both ends of the cylindrical tubular body portion 12having a main lumen or channel 14 provided therein. An inflatableballoonv 16 is provided adjacent the catheter distal end, said balloonoverlying the body portion 12 and being secured thereto by any desirablemeans, such as by ccmenting'or dipping, as'will be seen most clearly 'inFig. 2. An inflating lumen 18, also carried within body portion 12,communi+ cates with the balloon 16, whereby air or fluidunder pressuremay be introduced into said balloon'to disten'd same.

Conventional outlets 20 and 22 communicate with the lumens 14 and18,'respectively. V k

A balloon unit 24 isslidably mounted on the body portion 12 and includesa relatively thick central tubular portion 26 having secured thereto by.any desirable means} such as cementing, an expansible balloon 28," saidballoon having a rear extension 30, through which extends an inflationtube 32, whereby air or fluid under pressure may be introduced into theballoon 28 to inflate same. It will be noted that the balloon 28 issubstantially triangular in cross section and that the base of thetriangle is disposed toward the catheter distal end. It will further benoted that the base end 34 of the balloon 28 is secured to the theballoon unit 24 as a whole may be slidably moved. along body portion 12until the desired location of the.

balloon unit is achieved. Once the balloon 28 is dis tended, however,the pressure created by the inflation of the balloon will serve tomaintain the unit in its desired FttenieaM 7, 19st;

40 is provided in tubular body portion 12 intermediate the balloons 16and 28, said eye communicating with the main lumenor channel 14. It hasbeen .foundthat-best results are obtainedwhen theeyeldfl islocatedadjacent the distal balloonlfi. I In operation and use, my catheter isinserted into the urethral tract so .that the'balloon 16 is positionedwithin the bladder, .and then said balloon is inflated with air. .Theinflated bulb is drawn tight against the sphincter, or internal end ofthe urethra, and injection of the contrast media begun so as to clearthe system of air and urine. As soon as reflux appears at the externalmeatus, or external urethra end, the sliding balloon 28 is advancedagainst the meatus and inflated, traction on the vesical balloon beingmaintained until inflation of the sliding balloon is completed. Theinjection of the contrast media can now be completed, an additionalthree or four cc. usually suflicing to distend and outline the urethraadequate'ly. Prior to injection'of contrast media, it is important tostrip the urethra digitally, so as to evacuate any pockets of urine orpus present. After completion of the foregoing steps, radiographic studyof the area involved will permit visualization of the diverticulapresent.

As will be obvious, it is important that the balloons 28 and 16effectively block off the urethra orifices whereby to prevent anyleakage of the contrast media, but at the same time, it is importantthat said balloons do not extend into the urethra for any substantialdistance, since such a condition would cover up part of the urethralwall and thereby render visualization of diverticula located in thiscovered-up area impossible. For this reason, the balloon 28 is providedwith its substantially flat bottom 34, which bottom is in alignment withthe end 38 of tube 26, as aforedescribed. This particular configurationhas proven to be extremely .efiective in connection with the blockingoif of the external urethra end. On the other hand, it

has been found that the contour of the bladder is suchthat a roundedballoon, such as 16, ismore effective in blocking off the internalurethra end. As will be obvious, the adjustability of the balloon 28enables the catheter to be effectively set up and used in connectionwith diflerent individuals. 7

While there is shown and described herein certain specific structureembodying the invention, it will be manifest to those skilled in the artthat various modifications and rearrangements of the parts may be madewithout departing from the spirit and scope ofthe underlying inventiveconcept and that the same is not limited to the particular forms hereinshown and described except in so far as indicated by the scope of theappended claims.

I claim: v

1.. A positive pressure catheter comprising a tubular body portionhaving a longitudinally extending lumen therein, a first inflatableballoon carried by said body portion adjacent the catheter distal end,and aninflatable balloon unit slidably mounted on the body portion inspaced relation to said first balloon, the body portion having aninflation passage in its wall communicating with the interior of saidfirst balloon, said inflatable balloon unit including a. flexiblecentral tubular portion of appreciable Wall thickness slidable on thecatheter body portion, a second inflatable balloon secured to saidcentral tubular portion, an inflation tube communicating withtheinterior of-said second balloon, and an eye in said catheter tubularportion located intermediate said first and second balloons andcommunicating with said longitudinally extending lumen. 1

2. A positive-pressure catheter comprising a tubular body portion havinga longitudinally extending lumen therein, a first inflatable ballooncarried by said body portion adjacent the catheter distal end, a secondinflatable balloon slidablycarricd by said body portion in spacedrelation with'said first balloon, and an eye in said tubular portionlocated intermediate said first and "second balloons and communicatingwith said longitudinally extending lumen,,said second balloon being ofsubstantially triangular configuration and having its base end disposedtoward the .catheterdistal end.- I

3. A positive pressure catheter comprising a tubular body portion havinga longitudinally extending lumen therein, a first-inflatable ballooncarried by said body-poi. tion adjacent the catheter distal end, and aninflatable balloon unit slidably mounted on the body portion in spacedrelation to said first balloon,- the body portion having an inflationpassage in its wall communicating with the interior of said firstballoon, said inflatable balloon unit including a flexible centraltubular portion of appreciable wall thickness slidable on the catheterbody portion, a second inflatable balloonsecured to said central tubularportion, .an. inflation tube communicating with the in: terior of saidsecond balloon, and an eye in said catheter tubular portionlocatedintermediate said first and second balloons and communicating withsaidlongitudinally extending lumen, said second balloon being ofsubstantially triangular configuration andhaving its base end disposedtoward thecatheter distal end.

4. 'In the catheter of claim 3, said second balloon base endbeingsubstantially flush with the adjacent end of the central tubularportion.

References Cited in the file of this patent UNITED STATES PATENTS2,547,758 Keeling A es, *1951' 2,642,874 Keeling June 23, 1953 2,687,131Raiche Aug. 24, 1954

